Provider Demographics
NPI:1104834092
Name:MULLETT, WILLIAM E (EDD LPC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:MULLETT
Suffix:
Gender:M
Credentials:EDD LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 WASHINGTON ST W STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-2348
Mailing Address - Country:US
Mailing Address - Phone:304-539-0342
Mailing Address - Fax:304-205-4054
Practice Address - Street 1:209 WASHINGTON ST W STE 200
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-2348
Practice Address - Country:US
Practice Address - Phone:304-539-0342
Practice Address - Fax:304-205-4054
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional